Washington D.C., USA, July 2012www.aids2012.org Supporting MSM and TGs, Nepal Leads the Way Kabiraj Khanal MoHP 27 July, 2012

Washington D.C., USA, July 2012www.aids2012.org Outline Status and trend of HIV prevalence Routs and MARGs Plans and Programs of GoN Activities in collaboration with CSOs Other Govt Activities

Washington D.C., USA, July 2012www.aids2012.org Selected Indicators, Nepal, 2011 Year Total Population26.7 mn2011 % of Adult Population Prevalence of HIV Estimated No of HIV infections50, Adult male % Adult Female % < 15 yrs old % Reported HIV infections19,118 (Male- 65%, Female- 35%) 2012 No of ART sites26 centres, 10 sub centres2011

Washington D.C., USA, July 2012www.aids2012.org HIV Infections Estimates, Nepal, 2011

Washington D.C., USA, July 2012www.aids2012.org Size of population groups (most at risk) Nepal, 2011 Population groupsAdult (15-49) Population, 2011 People who inject drugs (PWIDs) 31,308 All Men who have sex with Men (MSM) 256,600 Male Sex Workers, TG and Clients (MTC) 75,142 Other MSM (other gay men who do not sell and buy sex) 181,458 Female Sex Workers 26,878 Clients of FSWs 741,824 Male labour migrants (to India) 1,322,612 Male remaining population 4,569,254 Female remaining population 7,304,546

Washington D.C., USA, July 2012www.aids2012.org HIV Infections Estimates among Adults, by Sub Groups, Nepal, 2011 Population Groups Estimated HIV Infections Proportion (%) People who Inject Drugs (PWIDs) MSW, TG and Clients 3, Other MSM who do not sell and/or buy sex 6, Female Sex Workers (FSWs) Clients of FSWs 1, Male Labour Migrants 11, Remaining Male Population 6, Remaining Female Population 11, Total 43,

Washington D.C., USA, July 2012www.aids2012.org Estimated Number of HIV Infections and HIV Prevalence, %

Washington D.C., USA, July 2012www.aids2012.org Trend of Estimated Adult HIV Infections among Risk Groups:

Washington D.C., USA, July 2012www.aids2012.org Reported cases of HIV infections by sub groups and Sex, July 2011

Washington D.C., USA, July 2012www.aids2012.org Routes of Transmission among Reported HIV cases, 2011 N = 2,060

Washington D.C., USA, July 2012www.aids2012.org Where is the risk that fuels HIV in Nepal? WomenMen Men visit sex workers Men visit sex workers Women married to men who visit sex workers Women married to men who visit sex workers Men who inject drugs Men who have sex with men Women who sell sex Infants and children

Washington D.C., USA, July 2012www.aids2012.org What GoN is Doing? Implementing NHSP II ( ) Developed National HIV AIDS Strategy in 2011 A No. of other sectoral policies and plans Provides services through its outlets Supports CSOs in implementing various Programmes

Washington D.C., USA, July 2012www.aids2012.org Major targets of NSP 2011 Compared to baseline figure of 2010: Reduce HIV transmission by half by 2016 – MSM from 3.8 to 2.0 – MSWs from 5.2 to 2.5 Reduce HIV deaths by 25% by 2016 Reduce new HIV infection among children by 90% by 2016

Washington D.C., USA, July 2012www.aids2012.org Key Actions proposed in NSP Provide comprehensive priority interventions for MSM, MSW and TG – promoting condom use, water‐based lubricants, detecting and managing STIs, IEC through peer outreach; enabling people to know their HIV status and psychosocial and emotional counseling. Advocate MSMs’ right and needs with law enforcement, health service providers, and other stakeholders to respect, protect, and fulfill the rights of MSM,TG and meet their needs for services. Sensitize MSM, MSW and TG on the importance of legal services and lawyers providing these services.

Washington D.C., USA, July 2012www.aids2012.org Major Programs being implemented in Partnership Comprehensive HIV prevention program for MSM, MSW and TG (WB Pull fund, to NCASC to BDS) Comprehensive HIV prevention program for MSM, MSW and TG (GF R7, to FPAN to BDS) Capacity building and advocacy program for MSM, TG (GF R9, through PSI DIVA project to BDS – National Working Group is formed (Coordinated by MoHP) – Regional WGs are also formed Comprehensive HIV prevention program for MSM, MSW and TG (GF R10, to Save the Children to BDS) LGBTI children Study ( Save the children with BDS)

Washington D.C., USA, July 2012www.aids2012.org Major Programs being implemented, contd… NHRC has focal person and desk for LGBTI people and has started intern at NHRC from LGBTI community UNDP conducted Comprehensive HIV prevention program for MSM, MSW and TG from 2006 to UNDP supported BDS to amend proposed criminal code and civil code In 2011 UNAIDS supported research on TG community UNICEF is going to conduct capacity building program for adolescent MSM,TG in 2012 ( August to December) GoN provides Yearly Budget for LGBTI community

Washington D.C., USA, July 2012www.aids2012.org Other Key Activities GoN has formed a Committee to recommend on same sex marriage Supreme Court decriminalized the same sex relationship Mapping of Discriminatory legal provisions (on the basis of gender identity) is completed Directives is being developed to grant citizenship certificates on the basis of Gender Identity (others category) Program to protect rights of sexual minorities have been incorporated in 3 year NHRAP.

Washington D.C., USA, July 2012www.aids2012.org Thank you.